Babs0512

I have two tatoo's, one on my left lateral calf, the other starts on my right foot, around the ankle and up the side of my right calf a little way's - it's a floral tattoo. I am in administration - and when I wear skirts, everyone can see them. Not once has it affected my ability to do my job, or have I heard any negative comments. I get a lot of compliments on my floral tattoo - from young and old alike. I have never been into drugs, I don't own a motorcycle (never have), these were personal choices that I made at age 48 and 49 - I am now 50, and I plan to do a floral on my left ankle that travels up to my current tattoo and intertwines with it to make it more lady like. My nose is also pierced, a gift to my self at age 36 - and again, never been an issue. The only time I would require someone to cover a tat - would be in the case of something like a Nazi tattoo, a horror type tattoo, or a tat that could offend someone due to race, ethnicity, sex, religion, etc... otherwise, I have no problem with them. I have no problem with piercings either. It's the person behind the piercings and tat's that is important to me, I am a good judge of character, and I realize that body adornments are a personal choice, and they have been around since there have been humans. Times have changed, we should change with them. Just MHO. Blessings

I agree with you. Many of our MD's weren't ACLS certified. I took ACLS classes and recerts with MD's, and boy was it an eye opening experience for me! Talk about dumber than a box of rocks! Mostly, the code team ran the code, even with the MD present - for the reason you stated.

Wow, you are in a wicked, tough situation. If these nurses are not approachable, and you've already gone to the "manager", then continue up the chain of command. Make sure you have documented problems/schedule changes/ and possible interference in patient care - document your concerns and how these concerns were responded to. Keep in mind, once you do this, you may not be very popular - but even that should go away in time. I would be most concerned with the patients. If staff is leaving and/or the schedules are getting mixed up, this could seriously cause problems with patient care. I would keep a close eye in this area and document problems. This is the area that will get you taken seriously - and most likely have management act. For example, a schedule change was not brought to the staff attention, and two of four nurses showed up for a shift - doubling your patient load - in a NICU - that is VERY serious. Good luck dear, you will need it. Blessings

I have a tatoo on each ankle, and a nose stud. I had the nose stud for approx 16 years. Non of these things have kept me from being professional or doing my job. I have been hired as an ADON and DON with these items showing - since I always wear skirts to interviews. I have never been asked to remove my nose ring and would lose a job rather that do it. I am also 50 years old. My tats are 1 and 2 years old respectively. I plan to expand upon the one on my left ankle. It is a new world, just as in the past, attire that was once "banned" is now commonplace. My nose ring (stud) is small and most people don't even see it. My tats are personal to me, and I chose the least likely place on my body to wrinkle and age. You will see a time when the President of the United States has tats and or piercings. Maybe not in my lifetime, but certainly in our younger nurses lifetimes. I have never been into drugs or gangs - one shouldn't judge a book by it's cover. I have two folders FULL of awards for patient excellence - and you would be lucky to have me as your nurse, because I am experienced, have excellent assessment skills, and quite frankly, I ROCK as a nurse. Don't judge a book by it's cover, or you may lose a great employee or boss. Blessings

not if the patient takes the temp in front of you and you can verify it - than it is objective. If, on the other hand she tells you she took her temp and it was 99.1 orally - that is subjective.

I guess it would depend upon the hosptal's policy and procedures. When I worked the ER, one of us was assigned to in hosptial codes. So was a member of ICU. Both being ACLS certified. When I responded to hospital codes, I would usually "take over" the code and bark out orders (trying to get it organized). We are certifed to run a code without the physician present. Yes, when the MD is present, we would defer to MD (sometimes - you'd be surprised how many have no clue). We aren't going to lose the chance at saving a patient when you have several ACLS certified nurses in the room, RT would manage the airway and intubate, we would monitor the EKG, give epi, atropine, ... per ACLS protocol. If they were a diabetic, we would get a finger stick and if BS was low, and amp of D50 would go in. Well, you get the picture. I won't belabor the point. Usually, it wasn't an issue, the ER doc would come with me to the code - however, if he/she was already attending a code in the ER or a fresh MI and couldn't break away, it was up to the nurses to run the code.

I would have to agree w/ Grn tea - if it is charted that due date is...then weeks gestation would be objective. Esp w/ the US to back it up. Now, if the patient show up at your hospital, lets say she is from out of town, and you cannot verify DOC, you go by what she is telling you, and that is subjective. IMHO

I agree with the other posters, everything you expressed is perfectly professional and polite - go for it!

I agree, give your notice, and move on. They always reserve the right to fire you at will, and you are also an "at will" employee, work out your 4 weeks, don't want to burn any bridges, and enjoy school!. I work in Endicott - so when you graduate, or if you need a job in the interum, PM me. Blessings

If I may ask, what is your Master's in? Perhaps you can find employment in that field while waiting for the right LPN job to come along? Just my Don't be discouraged. LTC facilities are usually always looking for LPN's, have you considered this? Whatever you do, don't give up. Stay strong, and the right position will find you. Blessings

No, absolutely not. IMHO, a new grad needs some real life experience at being a nurse. Even starting out on a med surg floor, you will learn to be organized, prioritize, work on perfecting assessment skills, getting to know meds, dealing with crashing patients, putting together all that book smarts into real life situations - isn't easy. If you love psyc nursing, then apply after a couple of years of med surg. Psyc patients can have multiple co-morbidities - psyc patients can bottom out their blood sugar (who's going to know what to do, who's going to get that IV in to give D50?) Psyc patients can have MI's which can manifest in many different ways - what if their only complaint is a toothache - will you know how to assess them properly and completely without some experience? I'm going to say "NO" - Psyc patients can go into DKA, Thyroid storm, Myxedema coma or sudden cardiac death - will you know how to handle it and assess these patients properly? Will you know how to put symptoms together with meds? Will you know how to gather all the data before you call the physician and organize it? Will you be able to write a short, accurate progress note that covers the entire crisis? "No'. Trust me dear - been a nurse for 20 years. I've responded to codes on the Psyc unit where the RN's didn't know how to do these things - and the patient died as a result. Do yourself and the patients a favor - LEARN, hone your skills, make your mistakes and learn from them - do it before going into a non-clinical area - because your patients deserve that much. Blessings and good luck to you

In 20 years of nursing, I only saw a ghost at work once. I was in PACU, called in for a case in the middle of the night. So, most of the lights in the OR suite were turned off. I was at the desk, putting my purse down and looked up. Across the hall we had a holding area for patients who were next up for surgery. I saw the silloute of a man with a hat standing there, not looking at me, but down another hallway. Even though the OR suite is locked, the main doors next to PACU can be opened by pressing the plate on the wall - so my first thought was this was a visitor who got lost. I started to walk toward the man, when he began walking toward the side hall - I said "Excuse me sir, can I help you?" He went down the hall and I turned down the hall because I knew it was a dead end, the door being locked. But when I turned, he was no where to be found. There was absolutely no place he could have gone - he just wasn't there. I went back to PACU and realized I had seen a ghost. I live in a haunted house, so it didn't bother me, I was more concerned that I wasn't able to communicate with him and therefore help him. My patient came to PACU a few minutes later and I was busy with the patient. After I got the patient recovered, brought to the floor and got back to PACU to close up, I checked the waiting area again, this time turning the lights on, but no one was there and nothing was amiss. This was the "old" portion of the hospital - so who knows back in the 1920's when this part of the hospital was built, what type of ward it was. After that episode, I always looked for the man, especially when called in overnight - but I never saw him again.

Obviously you are in NY. I work for a LTC facility in Endicott (a suburb of Binghamton). We are always looking for nurses LPN's and RNs'. Rents are very much less expensive here than NYC. For a two bedroom apt, especially if it is in an older home, would run about $550.00/month or less. For a "perfect" apartment, updated, granite counters, your looking at $750 or more. PM me and I can give you contact information - but we only want people who really want to work - not those who want to work when it is convenient. Good luck and blessings

I work in a LTC facility in NY. We just recently had a code on our rehab unit. We have "crash carts" - without drugs, IV's etc... but it does contain BVM's, oral and nasopharengial airways, oxygen, paperwork, gloves, suction, AED etc.... We call a "code blue", once checking for responsiveness if none, we begin CPR. Someone calls 911, and we continue CPR until EMS arrives and they take over. We are not allowed mouth to mouth, but since we have ambu bags and masks, it's not necessary. As a former critical care nurse, it is very difficult for me to work a code in a LTC facility. I want to get that IV, give EPI, Atropine, blah, blah, blah.... it's sort of like nursing with your hands tied behind your back. It's an adjustment for sure. BTW, he didn't make it. It wasn't a wittnessed code, but in MHO, they should never have started CPR in the first place, as he was dead, dead - he had dependent lividity and was cold to touch. He must have died about an hour before being found, because he was seen eating dinner in the dining room an hour before, he had to have crashed within a few minutes of returning to his room. '

I had a nice "cushy" ADON position in a small facility. I had been there 11 months. I saw an ad for an ADON position in a larger facility with a SIGNIFICANT increase in pay ($20,000). So I applied. In my first interview with the DON, I was honest and said "If you're looking for a 'yes man', I am not your person". I was called back for a second interview with the DON - she told me she was going to be moving into the VP of nursing and she would like to "groom" me for her position - as the other current ADON "just didn't have what it takes" to be the DON. I then had a group interview with all the nurse managers. Long story short, I got the job. My boss was suppose to meet with me weekly for an hour - as a question/answer period, to tell me what I needed to work on, etc... This was often cancelled, by my boss, because of more "pressing" matters. I loved working there, I worked long hours and I learned much - but what I never learned was all these "committies" I was assigned to - some had very obscure names, and I wasn't certain what was expected of me. "Falls commitee was a no brainer" but "Administrative commitee" didn't tell me much. The meetings themselves weren't very informative - I found the majority sat around and talked about their weekends and such - so I never really understood their purpose. I worked there for two months, was called into my bosses office on a Monday ans she said "It's not working out, I have to let you go." I was shocked, no one (to include my boss) ever said anything to me about not doing a good job, or needing to improve in this area, and so on. I said "Why?" her response was "You're just not fitting in with the culture here" I said "What?" She repeated the same answer. I said "Look, I've never been fired before, so if for no other reason than for learning, please give me specifics as to where I faltered so this can be a learning experience for me." "Babs, it's nothing personal, you're just not fitting in with the culture here." I realized I wasn't going to get a straight answer - so I asked "What about a reference?" She said "I will give dates of employment and I will tell them that you are a very hard worker." She hugged me and wished me well. I was escorted to my office, given boxes to pack my stuff up, and escorted out of the building. I must say, that I have never figured out what she meant - I WANTED specifics, so I could learn, but was given nothing. Yes, it hurt, and hurt bad, but life goes on. I haven't been able to get a ADON or DON position since. Such is life. I feel your pain, been there. Blessings

Here, in NY, as an RN, I too was able to do concious sedation using versed/fentanyl or valium/morphine but never propofol. The patients had to be on O2, cardiac monitor, pulse ox, automatic BP, etc... We all had to be ACLS certified or PALS if it was a child and the crash cart had to be in the room. We also were credentialed by the hospital in concious sedation. My biggest beef with these procedures, is having to argue with the physician because the patient was "moving" and they would want to give them more of which ever drug - when their respiratory rate was 8 bpm - or their BP dropped into the 70's systolic - and the doc would say give more versed.... I would have to politely refuse - I remember a time when this situation happend, and I refused to give the med, the doc drew it up and gave it anyway - the patient ended up in ICU in near resp arrest. Narcan/Romazicon didn't help rouse the patient - my report CLEARLY stated my objection and refusal to give more medication - the reasons why, and the doc being an obstinate pie hole - did it anyway. The good news, the patient lived, and he never questioned my decisions after that. Lesson learned.

I'm a realist, I can be "blunt" when the situation warrents it, I can also gloss things over when the situation warrents it. I work very hard to be a patient advocate first, before anything else. I give hugs, kisses - and I've also bluntly told a patient, "You are being completely rude and obnoxious, KNOCK IT OFF!" Every situation is different, and a good nurse needs to be pliable enough to roll with the punches. One of the hardest things I've ever told a person was, "Go home from here today, and celebrate your life, make this Christmas very special and make lots of memories - because it will probably be the last Christmas you see." The man had asked me to be honest, and I was. He and his family thanked me. I heard he died 3 days after Christmas. Sometimes, you have to tell the patients what the doc's won't. Blessings

One of my best lessons, other than those that came from my making a mistake, came from a housekeeping person. I had this patient, Ca with mets pretty much everywhere. He was a quiet man, kind of stoic - whenever you asked him if he was in pain, he would often respond with "no, I'll tell ya when I'm hurting". That should have been my first clue - but he was alert and oriented, so I figured he would tell me, like he said. I was covering another nurse who was out on vacation - so I was fortunate to have him for several days. A couple of days later, this housekeeper came to me and said "It's probably not my place, but I think Mr. Jones is in pain." I said "I asked him if he was having pain about 10 minutes ago, he said "no". So she said "but there are many kinds of pain, I talk to him while I clean his room, and he said "I hurt everywhere, especially my heart because I'm not ready to die." The housekeeper said she sat with him and just let him talk - a luxury we nurses don't usually have with all that we have to do, and large assignments. I told her that I appreciate her telling me, and that I would follow up with Mr. Jones. I reminded the housekeeper, that she did the right thing, and it is ALL our place to let others know about a patient. She left smiling. I was bound and determined to find a way to spend a block of time with him, I looked at my meds still due, and the several complicated dressing changes I had to do (med surg at the time), the blood I had to hang, etc... and realized the only way to eek out time was during lunch. So I thought "Screw the rules", and when my lunch came, I brought it in to Mr. Jones room while he was eating and said "I heard we had a lunch date?" He looked at me strangely, but smirked. After a few minutes of silence, I said "Mr. Jones, I know you are in pain, please talk to me so I can help you." A few minutes later, he just started talking. Suffice it to say, he had a lot to say. I learned that to him, "pain" was something women had - for him "pain" was a "hurt" (terminology, got to find out the patients terminology for things) He hurt physically, mentally and spiritually - yes, often we treat pain as only physical, but like the house keeper told me "there are many kinds of pain". So, together Mr. Jones and I came up with a plan. When he was in physical pain, he would say "I hurt in my abdomen...a lot, a little, or in the middle" I asked the chaplain to come and see him, and I discussed with him possible medication for depression - and talking with a "counselor" - to which he was in agreement with. I also suggested he talk with his family about all that he is feeling and thinking about - he said "I don't want to burden them." So my response was "Ah, Mr. Jones, the burden is often that they want to help in some way, but don't know how - by telling them - your easing their burden." (line of poop, maybe, but it sounded good at the time.) I made sure all of this was passed in report, I called the physician, he ordered a psyc consult, and the chaplain was more than happy to come up on a scheduled daily basis to sit with Mr. Jones and talk to him. After that, It was easier to ease his physical pain since we now knew his terminology and ratings scale, the chaplains visits he looked forward to, and the psyc eval found he didn't warrant anti-depressives, but did set up a psychologist to visit with him a couple of times a week to assist him with his transition and eventual acceptance with dying. By the time I left a couple of weeks later, we were managing his physical pain, and his spiritual and emotional pain were also being met. He was actually "happy" and more outgoing. So, you never know who you can learn from. The house keeper didn't tell me anything I already didn't know - she just reminded me to pay attention to those things in all patients - and I am forever appreciative to her for that reminder. Blessings to you AICU

That's a great attitude. All nurses need to be able to take constructive criticism. Sometimes it is given quietly - one on one-, and other times, due to circumstances - like a code or other emergency, it is given in front of others - in either case - it doesn't mean your a "bad" nurse, just that it was something you needed to change, or do differently the next time. Never internalize constructive criticism, take it like a professional, learn from it, and move on. We've all been there. And we are better nurses for it. You have a bright future, give yourself permission to learn, and remember that this learning never stops - there will always be new lessons. These may come from a doctor, RT, PT, nurses aid, and yes - even housekeeping. Keep your mind open, and you will be a great nurse. Blessings

I agree, I've always drawn an aerobic and anerobic culture - each from a different site. That is a "set", and I haven't been scolded for it in the 17 years I worked in the hospital.

To the OP, once you've become more confident in yourself and more knowlegable as a nurse, you should find that you can leave work at work (most of the time). There will always be those cases that were difficult, or an error was made, or just a particular bad day - at those times, remember that you are only human and you did the very best you could. Blessings

I had a clinical instructor who told me the same thing, she just had it out for me. Years later, after another of her clinical groups raved about me to her, (I took the time to teach them and show them advanced clinical skills) she came to me and said "You've become a great nurse, my students love you..." then she offered me a job!! Keep your chin up, be respectful, work hard and believe in yourself. You can be successful at anything you put your mind to! Blessings.

Okay, my preceptor story. While in nursing school we were on the surgical unit - there was this one nurse - I'll call her "Attitude" - who was so nasty to the students and showed such contempt for us, that I never forgot her, she even reduced me to tears one day because I got nauseated taking care of a woman with peritonitis who's abdomen was left open to close by secondary intention. I had to do wet to dry dressing and cover the wound properly. My instructor stood by, as I was unpacking her abdomen - the smell was indescribable! I was a 1st year nursing student at the time, and I had to reach in to all the cavities, where my gloved hand would literally disappear, to get all the wet dressing out. I remember at the time, my "spirit" left my body and it was like I was watching from above. I got through it, never wrinkled my nose or anything. Apparently I chatted with the patient, but have no memory of this. After we were through, I went out into the hall, and felt like I was going to faint - so I slid down the wall to a sitting position. My instructor apologized to me, she said "this was NOT a 1st year patient, I didn't know - I'm so sorry - if you want to go home for the day, you can." When the feeling faint past, I went into the dirty utility room to wash up, and I was teary eyed thinking "What ever was I thinking becoming a nurse - I can't do this!" In walks "Attitude" and says, "Your pathetic, grow up and get a grip" in her most disdainful voice. I stuck it out, didn't go home, but I was ashamed that I had such a hard time with the sights and smells of that patient. I decided then to get a PT job as an NA at the same hospital - I figured that would cure me of my squeamishness. Fast forward. now I'm am RN, just past the boards, and same hospital hires me for their float staff. They send me to med surge to work with my preceptor for two weeks. I get to the floor, eager to start my day, who walks up to me but "Attitude" and with a sly smile says, "I'm your preceptor for the next two weeks!" I almost pooped my scrubs - my worst nightmare was in my face and I had to "prove myself" to her. She pretty much left me alone - except during med passes, and I would come to her with questions. This is how the question and answers would go: Me: "What do I do about blah, blah, blah..." Attitude would look at me with her most bored expression and say "What do you think you should do?" I'd stammer and say, "if I knew that, I wouldn't be coming to you!" Attitude: "yeah, well, what do you think you should do?" So I'd stammer and try to think of an answer, and I would give her an answer - Attitude would then say "yeah, and then..." I would answer some more. Attitude "yeah, so....?" So I would complete my answer and usually answer my question. Attitude "so go do it!" That's how it went for two weeks. I NEVER got her to answer one question. I hated her for that. During my last med pass needing Attitude to follow me around, I got to the last room, Attitude said "Your doing fine, just finish up this last room" and walked away. I got "A" beds meds ready, and as I walked into the room, "B" bed calls me over to ask me some questions. So, I'm talking with "B" bed and as I'm doing so, I give him the meds in my hand. He said "What's this one for?" I told him "It's a stool softener" "B" bed says "but I'm not having trouble going to the bathroom." and on it went, he questioned everyone of the pills, and I answered, and he took them. As I was walking out of the room, I realized what I had done, and I started to panic - I just knew I had flubbed up royally. I went to Attitude and told her what happened, I said "I'm going to be fired, aren't I" She said in her usual bored voice "No, it's my error, I should have been with you." She went ahead and took care of everything. She came to me afterward and said "Well, your dammed good at educating, you convinced "B" bed to take all those meds". Then she said "What have you learned from this experience?" I said "Well, if a patient questions a med, I should go back and double check the MAR" she said "And?" "I should have told "B" bed that I would be right with him, and finished giving the meds to "A" bed first." She said "Barb, you know more than you think you do, TRUST in yourself and what you know, problem solve step by step, eventually everything will fall into place." Well, she "passed" me, and I moved onto the next unit. It wasn't until YEARS later - that I said to her one day "Thank you for all you taught me when you precepted me." She said "You taught yourself, I was just your sounding board." I said, "No, you taught me a lot, and I wanted to say Thank you" she smiled and said "Well then, you're welcome." She looked at me and said "Barb, your one of the best nurses we have, next to me of course, I developed much respect for you over the years." I said "Attitude, why do you always come off like such a *****" She said "It's my reputation, so don't tarnish it by telling anyone about this discussion!" and yes, she continued to act like a *****, even to me. I knew better though. She had developed faith in me, and she taught me that I did indeed know more than I thought I did - and I learned to think things through step by step - and over the years, I noticed I didn't have to go step by step, I could get from A-Z without thinking about the steps in between. I never made the same med error again - Oh, I found new ways to make them, but never gave an entire cup of meds meant for one bed to another bed. But every error I made, I learned from. And, I can proudly say, that in 20 years of nursing, I've made only 10 med errors. Sometimes, things aren't always what they seem. It took me a while to figure that out. She was the best preceptor I'd ever had - and when I began precepting, I used some of her techniques, but I did it with a smile and patience. Nuff said.

I was taught in a deltoid muscle, 1 to 2cc depending on the size of the muscle, (old lady 1cc, body builder 2cc), in the glute, no more than 3 cc. For a infant or toddler, 1cc in the thigh. Sub q, no more than 1cc.

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